Healthcare Provider Details

I. General information

NPI: 1003585415
Provider Name (Legal Business Name): CAROLYN G NEWMAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MANNETTO CT
HUNTINGTON NY
11743-6603
US

IV. Provider business mailing address

1 MANNETTO CT
HUNTINGTON NY
11743-6603
US

V. Phone/Fax

Practice location:
  • Phone: 631-880-8478
  • Fax:
Mailing address:
  • Phone: 631-880-8478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: